Ingabe ingane yakho iwile ngenkathi idlala? Mhlawumbe ushelele wawa ebhayisikilini lakho washaya ikhanda lakho ndawana thize? Isikhathi esiningi, asizinaki kakhulu izinto ezinjengalezi, sicabanga ukuthi, "Oh... kumane nje kuyiqhubu elincane." Kodwa ngezinye izikhathi, ngisho nokulimala okuncane ekhanda kungaholela entweni engathí sina engathinta impilo yakho. Namuhla, sikhuluma ngesimo esingase senzeke ngaleso sikhathi, futhi singaba yingozi kakhulu uma singelashwa ngokushesha. Kwezokwelapha, lokhu sikubiza ngokuthi i-Epidural Hematoma, noma i-EDH ngamafuphi.
Kalula nje, iyini i-Epidural Hematoma (EDH)?
Cabanga ngobuchopho bethu njengento eyigugu kakhulu futhi ebuthakathaka. Ikhanda lethu eliqinile likhona ukuze libuvikele. Kodwa phakathi kwekhanda nobuchopho kunezinye izendlalelo ezintathu ezivikelayo. Lokhu sikubiza ngokuthi ama-meninge. Kulezi zendlalelo ezintathu, ungqimba olukhulu kakhulu, ngaphansi nje kwekhanda, lubizwa ngokuthi i-dura mater.
Manje, uma ushaywa kanzima ekhanda, umthambo wegazi ngaphakathi kwekhanda, umthambo noma ngezinye izikhathi umthambo, ungaqhuma. Uma uqhuma, igazi liqala ukuvuza. Leli gazi liqoqana esikhaleni esincane phakathi kwekhanda kanye ne-dura mater, isembozo sangaphandle sobuchopho. Lokhu kuhlangana kwegazi kubizwa ngokuthi i- `Epidural Hematoma (EDH)`.
Kalula nje, kufana namanzi avuza phakathi kongqimba lweplasta nodonga futhi avuvukale njengebhamuza. Njengoba leli qhubu legazi likhula kancane kancane, liqala ukungena ngaphakathi, okungukuthi, liye ebuchosheni bethu. Lokhu kusunduza kungabangela ukulimala kobuchopho. Lesi yisimo esibi kakhulu esidinga ukwelashwa okuphuthumayo.
Lesi simo sibizwa nangokuthi `i-Extradural Hematoma`. Ngokuvamile, lokhu kwaziwa nangokuthi `i-Traumatic Brain Injury (TBI)`, ukulimala kobuchopho okubangelwa ukulimala kwekhanda.
Sibi kangakanani lesi simo?
Yebo, i-`Epidural Hematoma (EDH)` iyisimo esibi kakhulu esingasongela impilo . Uma singelashwa ngokushesha, singabangela ukulimala kobuchopho okungapheli noma ngisho nokufa. Ngokusho kwemibiko, cishe abantu abayi-15% abathola lesi simo bayafa. Ngakho-ke, akulona neze umqondo omuhle ukuthatha ukulimala kwekhanda kalula.
Khumbula njalo ukuthi noma yikuphi ukulimala ekhanda, kungakhathaliseki ukuthi kuncane kangakanani, kungaba kubi kakhulu. Funa usizo lwezokwelapha ngokushesha, ikakhulukazi uma kukhona ushintsho ekuziphatheni ngemva kwengozi.
Ubani osengozini enkulu?
Nakuba lesi simo singaba khona kunoma ubani olimele ekhanda, abanye abantu basengozini enkulu.
- Intsha: Lesi simo sivame kakhulu phakathi kwentsha.
- Abantu abaphukile ugebhezi: Le ngozi iphezulu kakhulu ezingozini lapho ugebhezi luphukile khona.
- Abantu bezemidlalo: Abantu abadlala imidlalo, ikakhulukazi ukugibela ibhayisikili, ukuskeyitha, i-rugby, kanye nekhilikithi, basengozini enkulu yezingozi.
- Izingozi zezimoto: Lesi simo singabangelwa ukulimala ekhanda ezingozini zezimoto noma zezithuthuthu, okuvame kakhulu eSri Lanka.
- Amadoda: Amadoda anamathuba aphindwe kane okuthola i-EDH kunabesifazane.
Lesi simo asivamile ukwenzeka ezinganeni ezingaphansi kweminyaka emibili ubudala kanye nakubantu abangaphezu kweminyaka engama-60 ubudala.
Ziyini izimpawu zalokhu? Ungakubona kanjani?
Into eyingozi kakhulu futhi eyingqayizivele ngalokhu yindlela izimpawu ezibonakala ngayo. Ezimweni eziningi, kodwa hhayi wonke umuntu, ungabona le ndlela:
1. Ukulahlekelwa kokuqala kokuzwa: Ngemva nje kokulimala ekhanda, ukuzwa kuyalahleka imizuzwana noma imizuzu embalwa.
2. Isikhawu Esicacile: Bese ubuyela engqondweni, ukhulume ngendlela evamile sengathi akukho okungahambi kahle, bese uzizwa uphilile amahora ambalwa. Lesi sikhathi sibizwa ngokuthi 'Isikhawu Esicacile'. Lesi yisikhathi esiyingozi kakhulu nesidukisayo . Ngoba uma uthatha isiguli usiyise ekhaya ucabanga ukuthi siphilile, kungaba yinkinga enkulu.
3. Ukuwohloka okusheshayo: Ngemva kwamahora ambalwa, lapho ihlule legazi eliqongeleleke ngaphakathi liqala ukucindezela ubuchopho, isimo sesiguli siba sibi ngokuzumayo. Bangase baphinde balahlekelwe ingqondo futhi baze bafike e-coma.
Ngaphezu kwale ndlela eyinhloko, lezi zimpawu zingavela kungakapheli imizuzu kuya emahoreni ngemva kwengozi.
| Isibonakaliso | Incazelo |
|---|---|
| Ikhanda elibuhlungu kakhulu | Akufani nekhanda elivamile, kungaba ikhanda elibuhlungu elinzima elingabekezeleleki. |
| Isicanucanu nokuhlanza | Isicanucanu nokuhlanza ngaphandle kwesizathu esicacile. |
| Ukwandiswa kweso elimnyama leso elilodwa | Uma ubheka izimbotshana zamehlo womabili, uzobona ukuthi elinye likhulu kunelinye. Lokhu kuyisibonakaliso sokucindezeleka ebuchosheni. |
| Ukudideka | Ulahlekelwa yinkumbulo yakho yokuthi ukuphi, isikhathi sini, nokuthi kwenzekeni, futhi uzizwa ungakhululekile. |
| Ukuguquka kwendaba | Amagama awakwazi ukuphinyiselwa ngokucacile. |
| Isiyezi kanye nokungabi nangqondo | Uhlangothi olulodwa lomzimba, isibonelo ingalo nemilenze yesokudla, lungase luzwakale sengathi lulahlekelwa ukuphila kwalo. |
Uma isimo siba sibi kakhulu...
Uma ukopha kungayeki futhi kungelashwa, ingcindezi ebuchosheni izokwanda futhi izimpawu zizoba zimbi kakhulu.
- Ukuquleka
- Ubunzima bokuphefumula
- Ukulahlekelwa ukusebenza kobuchopho
- Isimo se-Coma
- Ukufa ekugcineni
Yini ebangela lokhu?
Imbangela eyinhloko ukulimala ekhanda . Cishe ama-75% amacala e-EDH ahambisana nokuphuka kwekhanda. Imbangela evame kakhulu ukuphuka kwethambo lesikhashana, ikakhulukazi ngaphezu kwendlebe, okubangela umonakalo emthanjeni ophakathi we-meningeal, umthambo wegazi odlula kuwo.
Kodwa akuvamile kakhulu, lesi simo singavela ngezinye izizathu ngaphandle kwengozi.
- Ukutheleleka/ithumba
- Izinkinga zokujiya kwegazi (i-Coagulopathy)
- Izimila zobuchopho ezihambisana nokopha kwegazi
- Ukukhubazeka kwemithambo yegazi
Odokotela bakuthola kanjani lokhu?
Uma umuntu elethwa esibhedlela ngemuva kokulimala ekhanda, ikakhulukazi uma enezimpawu ezishiwo ngaphambilini, odokotela bazokwenza izivivinyo eziningana ngokushesha.
- I-CT scan (i-Computed Tomography): Lena yindlela eyinhloko neshesha kakhulu. Kufana nokuthatha isithombe se-X-ray esinezinhlangothi ezintathu (3D) sangaphakathi kwekhanda. Lokhu kungabona ngokucacile ukuthi ihlule legazi likuphi, ubukhulu balo, nokuthi licindezela kangakanani ubuchopho.
- Ukuskena kwe-MRI (Ukufanekisa Ukuzwakala Kwe-Magnetic):Lokhu futhi kuyindlela yokuhlola ngaphakathi kobuchopho. Kunemininingwane eminingi kune-CT scan, kodwa ngokuvamile kuyi-scan yokuqala eyenziwa esimweni esiphuthumayo.
- Ukuhlolwa kwegazi: Ngezinye izikhathi ukuhlolwa kwegazi kwenziwa ukuze kubonakale ukuthi kukhona yini inkinga yokujiya kwegazi.
Ilashwa kanjani? Ingabe ukuhlinzwa kuyadingeka?
I-epidural hematoma iyisimo esiphuthumayo sezokwelapha esivame ukudinga ukuhlinzwa okusheshayo . Ngaphandle kokukhululeka ekucindezelweni ebuchosheni, ukulimala kobuchopho okungapheli noma ukufa kungenzeka. Isinqumo sokudinga ukuhlinzwa sisekelwe ezintweni ezifana nalezi:
- Isiguli sinobuhlungu bekhanda obukhulu.
- Ukwehla kokusebenza kobuchopho (ukulahlekelwa inkumbulo, ukudideka).
- Kutholakale ihlule legazi elikhulu (i-hematoma) ku-CT scan.
Ukuhlinzwa
Kunezindlela ezimbili eziyinhloko zokuhlinzwa.
1. Ukususwa kwe-craniotomy kanye ne-Hematoma: Lena inqubo evame kakhulu. Kule nqubo, udokotela ohlinzayo ususa ingxenye encane yekhanda okwesikhashana futhi asuse ngokuphelele ihlule legazi elingaphakathi. Umthambo wegazi uyahlonzwa futhi umiswe, bese ingxenye yekhanda esusiwe ixhunywa kabusha ngephini elincane.
2. Imigodi Yokubhoboza: Enye indlela ukubhoboza imbobo eyodwa noma ngaphezulu encane ekhanda bese ukhipha igazi ngayo. Le ndlela inganciphisa ngokushesha ingcindezi ebuchosheni. Ngezinye izikhathi ipayipi lishiywa endaweni yalo izinsuku ezimbalwa ngemva kokuhlinzwa ukuze kususwe noma yiliphi igazi eliqhubeka nokuqongelela.
Ukwelashwa Okungaguquguquki
Ngezinye izikhathi, uma ihlule legazi lincane kakhulu, lingacindezeli kakhulu ebuchosheni, futhi isiguli singenazo izimpawu ezibucayi, odokotela bangase banqume ukungahlinzi. Ezimweni ezinjalo, isiguli sigcinwa egunjini lokunakekelwa okujulile (ICU) futhi siqashwe ngokucophelela nge-CT scans ejwayelekile ukuze kubonakale ukuthi ihlule legazi liyakhula yini. Imizimba yethu ingaphinde imunce inani elincane legazi ngokuhamba kwesikhathi.
Ezinye izindlela zokwelapha
Ngemva kokuhlinzwa, imithi efana ne-"mannitol, i-hypertonic saline" inikezwa ukunciphisa ukuvuvukala kanye nengcindezi ebuchosheni. Futhi, njengoba kunengozi yokuxhuzula ngemva kokulimala ekhanda, ngezinye izikhathi kunikezwa imithi yokuvimbela lokhu.
Uma kukhona umonakalo ebuchosheni, ukwelashwa kokuvuselelwa njengokwelashwa ngokomzimba, ukwelashwa ngokomsebenzi, kanye nokwelashwa ngokukhuluma kungadingeka ukuze kusizwe isiguli silulame.
Uyini umehluko phakathi kwe-Epidural ne-Subdural Hematoma?
Kungenzeka ukuthi uke wezwa nge-'Subdural Hematoma'. Nakuba zombili ziphuma igazi ebuchosheni, kunomehluko ocacile phakathi kwazo zombili. Lokhu kubalulekile futhi ukukwazi.
| Isici | I-Epidural Hematoma (EDH) | I-Hematoma ye-Subdural |
|---|---|---|
| Indawo yokuhlanganisa igazi | Phakathi kogebhezi kanye nesembozo sangaphandle sobuchopho (i-dura mater). | Phakathi kwe-Dura Mater kanye nesembozo sesibili ngaphansi kwayo (i-Arachnoid). |
| Umthambo wegazi obangela | Ngokuvamile kubangelwa ukuqhekeka komthambo wegazi. Ukopha kuyashesha . | Ngokuvamile kubangelwa umthambo odabukile. Ukopha kwenzeka kancane kancane . |
| Izimpawu ziyavela | Ivela ngokushesha (phakathi namahora ambalwa) ngemva kwengozi. | Kungase kubonakale kancane kancane (ngisho nangemva kwezinsuku noma amasonto). |
| Ngokuvamile kwenzeka | Kwabancane, ezingozini lapho ugebhezi luqhekeka khona. | Kuvamile kubantu asebekhulile (ubuchopho buyancipha njengoba buguga, okubangela ukuvaleka kwemithambo yegazi) |
| Izinga lokutakula | Izinga lokwelapha liphezulu uma litholakala futhi lelashwa kusenesikhathi . | Izinga lokufa liphezulu kunele-Epidural Hematoma. |
Yini okufanele uyenze uma umuntu oshaye ikhanda lakhe enalezi zimpawu?
Lena yingxenye ebaluleke kakhulu. Uma wena noma othile omaziyo enezimpawu ezilandelayo ngemuva kokushaya ikhanda lakhe,Myise e-Emergency Treatment Unit (ETU) yesibhedlela esiseduze ngokushesha.
- Uma ulahlekelwa ingqondo (ngisho nomzuzwana)
- Uma unekhanda elibuhlungu kakhulu
- Uma indaba ihlangana
- Uma uzizwa udidekile noma ulele
- Uma kwenzeka ukuhlanza
- Uma amasongo amnyama emehlweni womabili engafani (uma elilodwa likhulu)
- Uma unesiyezi noma ubunzima bokuhamba
- Uma uhlangothi olulodwa lomzimba luzizwa lungenampilo
- Uma kwenzeka ukuxhuzula
Khumbula, uphawu oluyinhloko lwe-'Epidural Hematoma' ukuthi isimo siba sibi kakhulu ngemva kokulimala ekhanda, bese sithuthuka isikhashana. Ngakho-ke ungahlali nje ekhaya ucabange ukuthi, "Sekulungile manje." Ngokuqinisekile bonana nodokotela.
Izingozi ezinje azinakuvinjelwa yini?
Asikwazi ukuvimbela izingozi nge-100% yesikhathi, kodwa kunezinto eziningi esingazenza ukuze sinciphise ingozi.
- Gqoka isigqoko sokuzivikela: Uma ugibela isithuthuthu, ibhayisikili, noma udlala imidlalo efana ne-rugby noma ikhilikithi, qiniseka ukuthi ugqoka isigqoko sokuzivikela esisezingeni elifanele.
- Gqoka ibhande lesihlalo: Gqoka ibhande lesihlalo noma nini lapho usemotweni.
- Sebenzisa imishini yokuphepha: Gqoka izigqoko zokuphepha ezifanele uma usebenza ezindaweni eziphakeme, embonini yokwakha, noma kunoma yimuphi umsebenzi ongaba yingozi ekhanda lakho.
- Gwema ukucwila ezindaweni ezingaziwa: Gwema ukucwila emifuleni nasemifudlaneni engaziwa, njengoba kungase kube namatshe noma ezinye izithiyo.
Umlayezo Wokuya Nawe Ekhaya
- I-Epidural Hematoma (EDH) yisimo esibi kakhulu, esisongela impilo lapho igazi liqongelela khona phakathi kogebhezi kanye nesembozo sangaphandle sobuchopho, okubeka ingcindezi ebuchosheni.
- Esinye sezimpawu eziyingozi kakhulu zokuphazamiseka kwengqondo isikhathi esifushane sokungazi lutho, kulandelwe amahora ambalwa okululama, kulandelwe ukuba kubi kakhulu kwesimo (i-Lucid Interval).
- Ikhanda elibuhlungu kakhulu, ukuhlanza, iso elimnyama elikhulu, ukudideka, kanye nokukhuluma okungacacile kuyizimpawu ezidinga ukunakekelwa okusheshayo.
- Ungakushayi indiva ukulimala kwekhanda, kungakhathaliseki ukuthi kuncane kangakanani. Uma unezinye zezimpawu ezingenhla, hamba uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela ngokushesha.
- Uma ihlule legazi litholakala kusenesikhathi futhi lisuswe ngokuhlinzwa, amathuba okululama ngokugcwele aphezulu kakhulu. Ukubambezeleka kungaba yingozi empilweni.
- Vikela ikhanda lakho ezingozini ezinkulu kangaka ngokusebenzisa izigqoko zokuzivikela namabhande esihlalo.
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